September 01, 2025
Botswana eliminates pediatric HIV.
Last week, Botswana became the first African country to secure the World Health Organization’s Gold Tier certification for eliminating mother-to-child transmission of HIV. While political will, universal access to maternity services, and the early adoption of lifelong maternal antiretroviral therapy contributed to this achievement, integrating HIV prevention and treatment into primary care was crucial. Amid declining international aid that threatens HIV response efforts in other countries, Botswana’s proactive, multifaceted approach showcases the impact of an effective and scalable framework. [Nature Africa]
The link between multidrug resistance and non-communicable diseases
The syndemic relationship between multidrug-resistant (MDR) infections and non-communicable diseases (NCDs), such as cardiovascular disease, diabetes mellitus, and cancer, is particularly pressing in low- and middle-income countries and socially vulnerable communities in high-income countries. A growing number of studies have found unmistakable, reciprocal links between NCDs and MDR infections, including one retrospective study that found a greater proportion of MDR organisms in the wounds of diabetes patients compared to those of non-diabetic patients. Future research should adopt a syndemic approach to antimicrobial resistance to identify new relationships between MDR infections, NCDs, and social vulnerability. [Infectious Diseases and Therapy]
Healthcare-acquired multidrug-resistant bacteria in malnourished children in Niger
Nearly 70 percent of children under five hospitalized for severe acute malnutrition (SAM) in Niger who were not colonized with carbapenemase-producing Escherichia coli upon admission were found to have rectal colonization with carbapenemase-producing E. coli at discharge. The high acquisition rate of extended-spectrum beta-lactamase-producing pathogens observed in this study further reinforces accumulating evidence that antibiotic treatment, often necessary when treating patients with infections secondary to SAM, triggers long-term impacts on the gut microbiota. The increase in MDR E. coli colonization at discharge compared to admission highlights the risks of hospital-based transmission and acquisition of MDR pathogens, which is particularly concerning in vulnerable populations such as acutely malnourished children. [Nature Communications]
Mortality risk factors and concurrent infections in bacteremia patients
A retrospective study at a hospital in Istanbul, Turkey, between 2016 and 2024 found that elevated neutrophil-to-lymphocyte ratios and C-reactive protein levels and decreased albumin levels may predict poor clinical outcomes in patients with Staphylococcus aureus bacteremia (SAB). In-hospital mortality (9.8 percent) at the studied hospital was linked to independent risk factors, including age, leukemia, and low albumin level. Notably, SAB-related mortality was highest in patients with bacterial pulmonary infections – the mortality rate among patients with pneumonia was 42.3 percent. These findings emphasize the value of infection prevention and surveillance to improve health outcomes in patients with SAB. [Nature Scientific Reports]
Impacts of climate change on food security and zoonoses
A narrative review examines the impacts of climate change on the transmission of zoonotic and foodborne pathogens through agriculture and food systems. Extreme weather events caused by climate change, such as hurricanes, floods, and increased rainfall, can disseminate pathogens beyond their typical geospatial niches, leading to widespread contamination and increased human-wildlife spillover. These catastrophic events also affect food security by reducing crop productivity, disrupting food supply chains, and increasing the prevalence of food-borne illnesses, highlighting a need for investments in climate-smart agriculture and community-led advocacy for enhanced food safety protocols and policy. [International Journal of Emergency Medicine]
Low rates of recent AMR training among hospital physicians in Nigeria
A study assessing the knowledge, attitudes, and practices related to antibiotic use among physicians in a teaching hospital in Edo State, Nigeria, found that only 35.6 percent of participants had attended a recent training on antibiotic use despite generally high reported knowledge, confidence, and adherence to antibiotic prescribing guidelines. Nearly half of the participating doctors reported feeling very confident in their antibiotic prescribing decisions. However, the low rates of recency training raise concerns about the relevance and accuracy of physicians’ knowledge of best practices around antibiotic use and prescribing. [BMC Health Services Research]
Factors influencing the detection of zoonotic tuberculosis in humans
According to a recent systematic meta-analysis, factors such as detection methods, sample types, and geography modify the detection rates of human Mycobacterium bovis, a causative agent of zoonotic tuberculosis (TB). The use of raw dairy samples was linked to higher detection rates, reinforcing the relationship between the consumption of unpasteurized dairy products and zoonotic TB. The geographic disparities in detection rates, exemplified by the United States and the United Kingdom each accounting for eight percent of overall detection rates, may be explained by differences in TB prevalence, healthcare infrastructure, raw dairy product consumption, and diagnostic methods. [Veterinary Medicine and Science]
Understanding behaviors and knowledge of rabies risk in Timor-Leste
In a knowledge, attitudes, and practices study of communities in Timor-Leste at high risk for rabies, only around half of the participants had heard of rabies despite a high level of dog ownership (65.3 percent). Dogs play an important role as guardians, protectors, and companions in Timorese households, highlighting the need for increased community education and awareness campaigns as well as mass dog vaccination. Low healthcare-seeking behavior following a dog bite and the high proportion of domestic dogs that are free-roaming challenge long-term rabies management in Timor-Leste, but could be mitigated using a One Health approach that has been successfully leveraged for rabies prevention in other Southeast Asian countries. [Preventive Veterinary Medicine]
Cost and coverage assessment of avian flu vaccination
An analysis of a vaccination program against highly pathogenic avian influenza in Austrian poultry farms revealed that a nationwide, year-round vaccination strategy achieved the highest vaccination coverage and incurred the greatest associated costs, at approximately €29.7 million. While using a risk-based approach and limiting vaccination to farms in only very high-risk areas, reduced associated costs were reduced. This strategy also resulted in a decrease in vaccination coverage. High costs associated with post-vaccination surveillance indicate a need for more cost-effective diagnostic technologies and for integrating surveillance into routine veterinary practices. [Preventive Veterinary Medicine]
Early-onset sepsis calculator is safe and may reduce antibiotic exposure in newborns.
Findings from a cluster-randomized controlled trial of newborns at risk for early-onset sepsis (EOS) support the safety and effectiveness of an EOS calculator to reduce antibiotic exposure. Antibiotics for suspected EOS were initiated in 7.2 percent of participants in the EOS calculator arm compared to 26.6 percent of participants in the categorical guideline (control) arm, equivalent to an absolute risk reduction of 19.0 percent. Fewer harm criteria occurred in patients in the EOS calculator arm compared to the control arm, indicating that the EOS calculator was safe and even conferred a mild protective effect. Despite the likely presence of a minor confounding effect, the EOS calculator was still shown to be safe and effective at reducing antibiotic use in neonates at risk for EOS and could help revise categorical guidelines to protect newborns from the harms of antibiotic overuse. [eClinicalMedicine]
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